Tag: cancer

Let’s Talk Therapy

Did you know that about 50 percent, if not more, of cancer patients/warriors/survivors have some form of ptsd? Ptsd stands for post-traumatic stress disorder. Ptsd occurs when someone has experienced or witnessed a shocking, scary, terrifying, traumatic, or dangerous event. This leads them to over respond to any sort of trauma from thereafter in an often debilitating or exaggerated way and could affect the rest of their life. It is a terrible condition. Therapy is an absolute must to try to combat this condition.

As a two-time cancer patient, I can tell ya, this crap is real. It can be devastating, debilitating and down right crappy. You find yourself freaking out at the slightest twinge, expecting the worst and not even considering the best. You have a scan coming up and find yourself grabbing for the ativan just to make it through it. It can get pretty ridiculous. Logic tells you that everything will likely be fine, but it is tough to believe it because your past experiences have taught you otherwise.

Ok, it sounds awful right? Heart pounding, sweating, pulse racing, fear coursing through your veins, ibs gettin all crazy. But, here’s the good news. There really is help out there, if you are willing to pursue it. You do not have to remain a prisoner of this terrible thing. That option is therapy. I mean actual, dig deep, deal with your demons, full disclosure psychological therapy. As difficult as it is, it can help you deal with your demons and identify your triggers and develop strategies that can either help you deal with these episodes when they happen or prevent them from happening in the first place. It’s truly a possibility of all wins.

The bottom line is that if you really want to start living after fighting your toughest enemy ever, you have to deal with the leftovers. You just have to, or else the fight won’t seem worth it in the first place.

On that note, I’m off to my regularly scheduled therapy appt. Peaceful vibes and power wishes.

Dr. Katz

Feeling bloated all of a sudden? Don’t ignore it!

Have you ever suddenly noticed that your pants don’t fit right or that your skirt is now bulging out just over your abdomen and nowhere else. Do you now have a baby bump that is not an actually baby bump? Don’t ignore it.

Except for the rare possibility that you just ate 20 pounds of food at one sitting, there should be very few benign reasons why your abdomen should suddenly puff up like that. Yes it is possible that you could be really constipated or gassy and just need to fart it out, but unless your stomach is really rumbling that is not really possible.

So, what are the causes of increased bloating? Let’s go over a few

First, hormonal changes can cause bloat. As our progesterone and estrogen levels fluctuate, it can lead to water retention and bloating. Estrogen in particular can cause increase in fluid retention, especially when it is out of balance.

Second, insulin resistance is a popular cause of bloating. The eternal spare tire that you cannot get rid of no matter how much diet and exercise you do. You see, in a normal healthy body, you eat the perfect type of food for your body type at least three times a day and the pancreas then secretes just the right amount of insulin to break down the food into just the right amount of glucose to then get inserted into your muscles to give you energy. When you are insulin resistant, as the result of a crap shoot genetic gift from a relative or through the natural changes of aging and menopause, there are several issues. The first is that you are probably not eating right for your body type. You are probably over carbing because that is what you crave. Or, you are meal skipping especially in the mornings because your stomach is just not ready for food. In either case, the pancreas is over secreting insulin because it sees the extra carbs and freaks out, or it stores insulin because it thinks you are starving. On top of that, your body is not using the insulin it makes because your tissues are insulin resistant. This means that all that extra unused insulin just sits in the abdominal tissue, then calls in its friends fat and salt and water and blam! The extra bloat that won’t go away. If this goes on for enough years, eventually your pancreas goes on strike and you become diabetic instead.

Third, something more serious could be going on. Abdominal bloating seemingly out of no where could be due to fluid in the abdomen. This is called ascites. This could be due to liver disease, heart conditions, kidney disease, pancreatitis, infections or even cancer.

Fourth, and most serious, it could be due to a growing tumor in your abdomen with no symptoms to tip you off except for mild decrease in appetite, constipation, or bloating.

The bottom line is, bloating out of nowhere with no specific justifiable reason should not be ignored. It can be the sign of something serious so when all of a sudden those pants don’t fit or that skirt is too tight. Get it checked out!

Dr. Katz

Please, just leave the pelvises to me.

closeup photography of pink rose flower

Hey there folks. Dr, Katz here. I have been an Obgyn for the last 28 years. I have delivered thousands of babies. I have performed thousands of surgeries. I have done thousands of paps. All of these things are essential parts of the specialty that I was specifically trained for. I was also fortunate enough to have gone through residency at a time where Obgyn was temporarily reclassified as primary care so I also have training in internal medicine, er, icu, pediatrics, and family medicine. As a result, I know how to diagnose things outside the scope of regular Obgyn practice, but, at the same time, I realize that I am not the expert in those areas so I know when to refer when necessary.

Sometimes, I feel like the same does not apply to obgyn care. There are a lot of family physicians and internists out there that still do the occasional pap when they have to or if the patient does not want to visit an actual obgyn.

Most of the time you get lucky and the pap would have been normal regardless so no harm done. But, then there are those other times when the patient has been getting “normal” paps for years by their family doctor and then they come and see me and actually have an invasive cancer that could have been caught earlier. Thank goodness these times are rare, but they happen nonetheless and are preventable.

To me, this says don’t dabble. You are potentially putting someone’s life at risk, even if unintentionally. I know that a lot of people think that doing a pap is a no brainer and that is the complete story as far as Obyn. I tell ya. It’s not true. There is an art to it from the performing of the procedure without harming the patient and actually knowing what you are looking at and being able to pick up on the subtlest of cues that something is off. Obgyn stuff is that sneaky. You usually don’t get any symptoms until something is already bad. Then, it can be too late. However, if you just stop into the Obgyn once a year, a lot of that is both preventable and/or treatable.

I know how to treat blood pressures and treat a multitude of various diseases, but I know I am not the expert so I refer appropriately. I think that every patient needs a primary care physician and an Obgyn because they both care for different necessary aspects of health. I think that both are necessary to achieve total health and well-being. I think we are different specialties for a reason. All I’m asking is, please leave the vaginas and the pelvises to me. I promise I won’t let you down.

Dr.Katz

“You know you are not really out of the woods yet.  You still have to be careful.”

My first response to these loving words of protective advice is well….duh!!!! Do you honestly think I do not know that? Do you honestly think that I truly believe that my entire immune system has magically regenerated in just two to three months? I am here to reassure you that I don’t. I am still always careful. I know that I need to be. I’m not out there attending huge crowd events or stadium filled concerts. I know better.

However, it doesn’t mean that I have some random fomo moments. Actually they are not really fomo moments. They are actually just random blissful moments when I feel like I feel good enough to do something somewhat normal. That’s all they are. I am not actually going to rush out and do something ridiculous just because I mention an idea that just came into my head. Let me dream about it a second and allow me the time to process it and come to the correct conclusion on my own. I promise I won’t let myself or you down. I have come too far and worked way too hard to screw it up now. The crowds will always be there and hopefully I will too, when it’s safe and I am truly ready.

Thanks for listening guys.

Dr. Katz

Let’s Goooo!

Ok guys. Here is all the latest and greatest updates. My brain is cancer free and looks positively boringly normal! Yesss!

My vision is 20/15 with my glasses on and I am able to get rid of my bifocals! Yess!

My memory is doing pretty awesome and a lot of the short term loss has returned. Yess!

I am able to do complex puzzles and remember strings of 12 numbers. Yess!

My energy is good. I still have to have the occasional power nap, but who doesn’t? Yess!

My hemoglobin is finally in the normal range! Yess!

I am inches away from being granted full functioning privileges at the hospital with no restrictions! All the paperwork is in. Yess!

Obviously, I still have some precautions to follow with my baby immune system and all and I still need to get revaccinated for everything. But, it is truly time for everyone to bring the level of worry down to a healthier level. I totally get and appreciate all of it and I understand all of it. But, it is time to climb down from def con five level. We have done it folks! It is time to celebrate and live! I promise everyone that I am not going to do anything that I don’t truly feel ready for or that could put myself or anyone else in danger. Let’s do this! Have a great day!

Dr. Katz

Running mundane errands this morning

Ok so I woke up today on a Friday morning and realized I had the day off…First win of the day! Then, I realized that I was going to get to go to the fruit and veggie market and the grocery store..by MYSELF…driving my OWN CAR! Whaaaat? You are probably asking yourself….so, what’s the big deal? Well, the big deal is that something like that has not happened in like 8 months. 8 months of hospital prison, chemo, stem cell craziness, sepsis, isolation and just trying to make it out alive! This realization hit me like a kind of freight train out of nowhere, but in a good way. I was overcome with the sense of freedom and joy. I could not wait to carry out my little mundane tasks like a regular mom and wife with no risks or fears.

I practically trotted out to my car and literally patted her like we hadn’t seen each other in a long time. I jumped in and buckled my seat belt and blasted the AC DC and the Led Zeppelin with my McDonalds fountain coke in hand and jammed it out all the way to the fruit and veggie market. I was actually the first in line as the doors open. Of course, I was still careful and had my hand sanitizer in hand and my mask on, but I didn’t care! I was actually out by myself and got there without having to get a ride from someone. The fruit and veggie mart was cold like walking into a refrigerator. Lots of people were complaining. Not me! I can’t remember the last time I was cold and not just overheating. My little bald self was bouncin around that market like I had never been there. I even found myself humming a little tune. I think I amused the check out lady because she commented,” Having a good day are we?” I said ” We certainly are! I haven’t been out by myself in a very long time. I am super grateful.” I think I made her day, especially since everyone around me was complaining about the cold.

On the way home and to my next stop at the grocery store, I actually got misty eyed because I was so happy. I just couldn’t believe my good fortune at being able to do something this basic and simple. It’s amazing how much you forget enjoying the basics when you don’t get to do them for a long time. Well, on that overly happy sappy note, I bid all of you a wonderful day. Keep being grateful for what you have. Realize how good life can be before it slips away from you.

Dr. Katz

Someday I am going to have to relearn that one twinge somewhere does not have to mean that imminent doom is upon me.

Cancer related PTSD is real people. Did you realize that one in three cancer patients suffer from cancer-related PTSD? That is over 30 percent. That is actually a huge number. First of all what is PTSD? PTSD stands for post-traumatic stress disorder. Post traumatic stress and post traumatic stress disorder are two different things. Post traumatic stress is a normal response to a stressful event. It’s like getting nervous before a scan or a blood test. Post traumatic stress disorder takes things a step further. This consists of severe stress responses to triggers that last longer than 1 to 3 months. They are responses that are so severe that they can prevent you from going to appointments or even living your life. It can be very disabling. It is nothing to be taken likely.

So, who is at risk? Everyone who has had a specific traumatic experience is at potential risk of this. Some examples would be combat, abuse, assault, violence, mental or physical disasters, severe injury, or illness, like cancer. You are also more at risk if there is any previous history of anxiety or depression or you do not have a good support system.

You have to keep in mind that there is not one single cause of PTSD. It is different in terms of triggers and severity for everybody. The symptoms can range from nightmares and flashbacks or intrusive thoughts. There can be avoidance behaviors of people, places, or things. There can be a general disinterest in participation of any kind. There can be guilt or shame about your particular trauma. There can be insomnia. There can be a feeling of general disconnect. All of these are kind of attempted internal protection mechanisms that our brains come up with. But, none of them are actually helpful.

For me, the biggest trigger is any slight hint that something could be wrong such as a pain or a headache that I cannot explain. It immediately sets my brain off to a path of potential disaster if I don’t put a stop to it right away. I mean, to be fair, it makes sense, my previous headaches and pains led to me being in an unresponsive coma with a head full of brain tumor and mush. I am right to be leery and a little hypervigilant. It is my own hyper-vigilence that has helped save my life more than once. But,I still can’t let it rule my life. I have spent enough time locked up in hospitals and struggling to get people to listen. I can take a break right now. I have fought every fight with valiance. I have all the scans and the tests that prove that I am doing ok, including a scan that looks like an actual tumor-free brain. Win! I am going to admit that it is still a work in progress. It is hard not to jump to the bad news. I am just going to keep doing my best and not beat myself up about my jumping to possible bad conclusions. It is what is is. Every day I get to wake up and see the sunshine out of the window of my own house is a blessing. I just have to keep believing that the worst of days are behind me, and get help when I need it.

Dr. Katz

It’s kinda interesting how much lower your expectations get the more crappy stuff that happens to you.

closeup photography of pink rose flower

So, we all know I have been through some significant battles and stuff lately. Brain cancer, stem cell transplant, cannon ball chemo etc. I remember the days when the stuff that used to get me excited was that I won a contest or some kind of award or something. I’m not saying that that occurred that often, just noting that it was more high-end traditional kind of stuff that got me going and motivated.

Well no more ladies and gentleman! Now, I am excited about things like sort of being able to taste my food for the day, swallowing without pain, going a day without diarrhea or nausea. I am excited that I am able to take some steps without extreme exertion. I am excited that my mouth is no longer full of sores. I am excited just to open my eyes every day. I am thrilled to be back home in my own bed. It’s these basic little things that no longer seem so little that really make my day. I know it sounds silly but I really am genuinely about the gratitude for any of even the smallest triumphs. I really didn’t ever take anything for granted before but I feel like that is even more true now. Just thought I would put it out there. We all have our struggles, but I think it is the effort we make to get through them and how our perception can change for the positive that makes the biggest difference in how things can turn out. Have a great day everybody!

Dr. Katz

OMG I might get to go home in 2 or 3 days

As you all know I am plodding and racing at the same time to complete my stem cell journey hospital stay portion. I have been putting my steps in, keeping mobile. Gobbling all the antibiotics for all the infections. Trying to stay moving as my hemoglobin drops in over half. Having diarrhea all the time. Trying to croak just days before. A lot has turned around in a fast pace (if you can call a whole month in the hospital fast). This is girl is super grateful and happy to be alive. That Is the main glowing thought on my brain right now. I am filled with happiness and hope. I can swallow and sort of taste food again. All wins.

Naturally my family is nervous about me coming home. They don’t want me to rush. I tell them not to worry. That is definitely not what is going on here. There has been no rushing. I have no great impetus to hurry home in a rushed fashion. Of course I would love to go home…when it’s safe. I told them we have to trust that my doctors aren’t just trying to get rid of me. We are trying to strike that fine line of compromise and safety. If it ends being earlier than we thought, sounds like a win to me for all mine and their hard work. We have spent too much time with being scared. Now is the time for cautious optimism not fear. We have come too far. The doctors believe in me. My family can believe in me too. I know they can. Cheers to the thought of going home and beginning the next part of the adventure!

Dr. Katz

I really gotta concentrate on living right now and getting back home where I belong.

Boy this stem cell is tough. It’s really really tough. I have had to go through some really tough things before but I think this one is at the top of the list. I mean, I was prepared before I got here for this that is was going to be a rough road but sheesh it is exceeding even my pre expectations. I always like to consider myself a really prepared individual but I think it is impossible to completely prepare for something like this. You don’t really know, despite all the words, how it is actually going to be until you start doing it.

Let starts off with the first part. I am affectionately going to refer to it as the cannonball chemo part of the process. This is the part where they give you day after day of marrow ablating chemo to prep you for the process. I guess most people get two drugs. I got three. I guess most people take about 5 days to complete this process. Well I got so much chemo that it ended up being 8 straight days before any “rest time” was upon us. I asked why I got all the extra over the usual crowd. The answer was that they just knew I could handle it because I was so tough. Ummm. Thanks? But eek no thanks at the same time.

Of course. I did it anyway because it was what was recommended. I am one of those patients who tried to tread the line between following all directions and still advocating for myself. It’s a tough line sometimes. Ive noticed over the years that medical professionals are definitely not used to patients that are knowledgeable and engaged. Sometimes I feel like they see that as a threat and that they are just being inappropriately judged and questioned. Well that is definitely not the case in my case but it hurts my heart a little to think that maybe some medical professionals are not confident enough in the treatment they are giving to be threatened by questions. Personally I totally dig it when a patient is an active and knowledgeable and engaged team member. This totally makes my day. I wish everyone felt the same way. I think it would help us to better care for patients. It just makes the whole thing go better when you don’t just have a terrified submissive patient that doesn’t totally understands but just goes with what you say. I say this is never a good scenario and it is our job to reinforce to the patient that they, in fact, are the captain of their medical team and in charge of their bodies and their care, It has to be a balance of trust and communication. It is so important.

I get it that there are times when doctors just need to act and tell you what to do, especially in an emergency situation. Me back in December, head full of tumor and mush, suddenly collapsing after not being able to even remember her name or birthday and underwent emergency brain surgery. Scary crap and I get that there wasn’t really a lot of opportunity for my input at that time because I wasn’t even conscious at the time. Thank goodness the doctors took over and convinced my husband to stay put so they could forward with my surgery, get a sample and abruptly begin to halt the seizures and swelling that were going on in my beautiful but tortured brain. Thank God they did or I wouldn’t be here right now. Very grateful for that.

Sorry, back to present times again. I am nearing the point of the end of the inpatient stem cell journey. My counts have already done their plummet. My hemoglobin is down to 7. My platelets are barely measurable and I am super exhaustedI I had a scary time trying to go septic just days ago. Like, we could have been done septic. Yikes.

Well, I am very happy and grateful to report that today is starting in to the final path to the end of my hospital stay. Counts are trying to go back up. I am starting some cell stimulating injections and they say I could go home in as soon as a week. I can’t walk around in the hall anymore because of some opportunistic infections and that is frustrating because i want to be a part of my own recovery. But, it has given me time to sit in my room isolated and have time to write. See? The silver lining is always there if you look hard enough. I always try to maintain my not foolish but productive positive attitude. I really think it helps.

So, here’s to the next few days until i can get home to see my family, my pets, and my friends, and maybe even sleep in my own bed. I know that there will be no parties or large gatherings for months. But I’m doing this now so there can be later. Wish me luck!

Dr. Katz